Effect of Continuous Positive Airway Pressure Therapy on Glycemic Excursions and Insulin Sensitivity in Patients with Obstructive Sleep Apnea-hypopnea Syndrome and Type 2 Diabetes

Guo, Lixin; Zhao, Xin; Pan, Qi; Sun, Xin; Li, Hui; Wang, Xiaoxia; Zhang, Lina; Wang, Yao

doi:10.4103/0366-6999.163382

Cited by 18 publications

(19 citation statements)

References 21 publications

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“…Guo et al . [26] found that CPAP therapy may improving both blood glucose and insulin sensitivity in patient with diabetes and sleep apnea-hypopnea syndrome. Several mechanisms can interpret these associations.…”

Section: Discussionmentioning

confidence: 99%

Association between Self-reported Snoring and Prediabetes among Adults Aged 40 Years and Older without Diabetes

Wang

Yan

Dou

et al. 2017

Chinese Medical Journal

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Background:Several previous studies have shown that snoring is associated with glucose metabolism and the development of diabetes, but rare study has shown the association between snoring frequency and prediabetes, particularly in China. We hypothesized that individuals who snore might have a higher risk of prediabetes. This study aimed to investigate the association between self-reported snoring and prediabetes in a Chinese population.Methods:A cross-sectional study was performed in three large communities of Beijing from December 2011 to August 2012 by recruiting individuals aged ≥40 years old. All participants were requested to complete a detailed questionnaire and undergo anthropometric measurements. A 75 g oral glucose tolerance test was performed in individuals without diabetes. Blood samples of all participants were collected; blood glucose and blood fat levels were measured. Multivariate logistic regression models were built to assess the association between snoring frequency and prediabetes.Results:A total of 13,592 participants (female: 66.56%; mean age: 56.8 ± 7.9 years; mean body mass index: 25.5 ± 3.4 kg/m2) were included in the final analysis. Of these, 30.9% were diagnosed with prediabetes, while 41.3% and 25.4% had occasional and habitual snoring, respectively. Habitual snoring was associated with an increased risk of prediabetes (odds ratio [OR]: 1.3, 95% confidence interval [CI]: 1.1–1.4, P < 0.001), after adjusting for diabetes and sleep-related confounders in the multivariable models. Habitual snoring was also associated with isolated impaired fasting glucose (IFG; OR: 1.3, 95% CI: 1.0–1.6; P < 0.001) and isolated impaired glucose tolerance (IGT; OR: 1.3, 95% CI: 1.2–1.5; P < 0.001), but not IFG + IGT (OR: 1.1, 95% CI: 0.9–1.4; P = 0.281). When stratified by total cholesterol (TC) levels, this association between habitual snoring and prediabetes was observed only in individuals with TC <5.6 mmol/L (OR: 1.4, 95% CI: 1.2–1.6; P < 0.001).Conclusions:Habitual snoring is associated with prediabetes, but only in individuals with TC <5.6 mmol/L. Further prospective studies are needed to confirm this finding.

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Section: Discussionmentioning

confidence: 99%

Association between Self-reported Snoring and Prediabetes among Adults Aged 40 Years and Older without Diabetes

Wang

Yan

Dou

et al. 2017

Chinese Medical Journal

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“…The homeostasis model assessment of IR (HOMA-IR) was calculated using the following the formula: FINS (μg/ml) × FBG (mmol/L)/22.5. [ 15 ] Rats were subsequently subjected to an oral glucose tolerance test (OGTT) with glucose (2 g/kg, body weight [bw]) after fasting overnight (12 h). One week after the OGTT, an intraperitoneal insulin tolerance test (IPITT) with insulin (0.75 U/kg bw) was also performed after fasting for 7 h. Plasma glucose levels were measured by ACCU-CHEK Active Monitor (Roche Diagnostics, Basel, Switzerland) at 0, 30, 60, 90, and 120 min, and the area under the curve (AUC) was calculated.…”

Section: Ethodsmentioning

confidence: 99%

Effect of High-fat Diet-induced Disorders on Rat with Endometrial Hyperplasia and Adiponectin System in Circulation and Uterus

Shang

Liu

Wang

et al. 2017

Chinese Medical Journal

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Background:Epidemiologic and genetic studies suggest a link between insulin resistance (IR) and endometrial cancer, and endometrial hyperplasia (EH) is a precancerous stage of endometrial cancer. Adiponectin is an adipokine which previously shown to be a risk factor for endometrial cancer. The aim of the study was to develop a rat model of IR and EH and evaluate adiponectin system in circulation and uterus.Methods:This study was a 46-week animal trial from February 2014 to January 2015. Female Sprague-Dawley rats were fed with high-fat diet (HFD) for 40 weeks to induce IR. Followed by ovariectomization, rats were orally administrated to 17β-estradiol (E2) for 4 weeks to induce EH and then sacrificed. A total of 36 rats were divided into four groups: E2, HFD, HFD + E2, and control groups. Data were analyzed with Student's t-test, one-way analysis of variance (ANOVA), and Mann-Whitney U-tests. Chi-square was used to evaluate the score of immunohistochemistry.Results:The thickness of endometrial, glandular epithelium, and myometrium in the HFD-E2 group were higher than the E2 group (F = 59.02, F = 23.51 and F = 12.53, respectively, all P < 0.001). Plasma adiponectin levels in the E2 group were lower than those in the control group, and the levels in the HFD-E2 group were lower than those in the HFD group (F = 13.15, P < 0.05). However, after normalized to visceral adipose tissue, compared to the control group, plasma adiponectin levels were decreased in rat with HFD in the absence or presence of E2, respectively (F = 6.72, P < 0.05). Adiponectin gene (F = 10.48, P < 0.05) and protein (P < 0.05) levels in uterus in the HFD-E2 group were higher than those in the HFD group.Conclusions:This study manifests that IR can effectively modulate EH, which suggests the involvement of energetic metabolism in uterine alternation. The combination effects of IR and EH modulate circulating adiponectin levels. However, adiponectin gene and protein levels in uterus are mainly response to estradiol.

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“…To date, the effect of CPAP on GV determined by CGM in type 2 DM patients has been examined in five studies [ 22 – 25 , 42 ]. A significant reduction in GV that was assessed by MAGE or SD after CPAP treatment was reported by Pallayova et al [ 23 ] and Guo et al [ 24 ] but not by the other investigators [ 22 , 25 , 42 ]. Pallayova et al reported that SD and %CV were decreased rapidly with the initiation of CPAP therapy (i.e., during a CPAP titration night) [ 22 ].…”

Section: Discussionmentioning

confidence: 78%

“…Pallayova et al reported that SD and %CV were decreased rapidly with the initiation of CPAP therapy (i.e., during a CPAP titration night) [ 22 ]. In a study by Guo et al [ 30 ], 30 days of CPAP reduced MAGE and SD by 29% and 27%, respectively, in addition to reduction of HbA1c from 8.70% to 6.95% [ 24 ]. In the present study, adherence to CPAP was adequate (> 4 h/night), and the duration of CPAP was about 3 months.…”

Section: Discussionmentioning

confidence: 99%

Distinct impacts of sleep-disordered breathing on glycemic variability in patients with and without diabetes mellitus

et al. 2017

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BackgroundSleep-disordered breathing (SDB) is highly prevalent in patients with diabetes mellitus (DM) and heart failure (HF) and contributes to poor cardiovascular outcomes. Enlarged glycemic variability (GV) is a risk factor of cardiac events independently of average blood glucose level, but the influence of SDB on GV is uncertain. In this study, we examined whether the impact of SDB on GV is modified by the presence of DM with or without HF.Methods and resultsTwo hundred three patients (67.5±14.1 [SD] years old, 132 males) who were admitted to our institute for examination or treatment of DM and/or HF underwent continuous glucose monitoring and polysomnography. Both HbA1c (8.0±2.0 vs. 5.7±0.4%) and mean amplitude of glycemic excursion (MAGE, median: 95.5 vs. 63.5 mg/dl) were significantly higher in a DM group (n = 100) than in a non-DM group (n = 103), but apnea-hypopnea index (AHI: 29.0±22.7 vs. 29.3±21.5) was similar in the two groups. AHI was correlated with log MAGE in the non-DM group but not in the DM group, and multivariate regression analysis revealed that AHI was an independent variable for log MAGE in the non-DM group but not in the DM group. We then divided the non-DM patients into two subgroups according to BNP level (100 pg/ml). AHI was positively correlated with log MAGE (r = 0.74, p<0.001) in the non-DM low-BNP subgroup, but such a correlation was not found in the non-DM high-BNP subgroup. Continuous positive airway pressure (CPAP) reduced MAGE from 75.3 to 53.0 mg/dl in the non-DM group but did not reduce MAGE in the DM group.ConclusionSeverity of SDB was associated with higher GV, but DM as well as HF diminished the contribution of SDB to GV. Treatment with CPAP was effective for reduction of GV only in patients without DM.

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Effect of Continuous Positive Airway Pressure Therapy on Glycemic Excursions and Insulin Sensitivity in Patients with Obstructive Sleep Apnea-hypopnea Syndrome and Type 2 Diabetes

Cited by 18 publications

References 21 publications

Association between Self-reported Snoring and Prediabetes among Adults Aged 40 Years and Older without Diabetes

Association between Self-reported Snoring and Prediabetes among Adults Aged 40 Years and Older without Diabetes

Effect of High-fat Diet-induced Disorders on Rat with Endometrial Hyperplasia and Adiponectin System in Circulation and Uterus

Distinct impacts of sleep-disordered breathing on glycemic variability in patients with and without diabetes mellitus

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